(HealthDay News) — A publicly available model can identify patients with asymptomatic Waldenström macroglobulinemia (AWM) at high risk for progression, according to a study published online April 16 in the Journal of Clinical Oncology.

Mark Bustoros, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues reviewed the cases of 439 patients with AWM, who were diagnosed and observed at a single institution between 1992 and 2014.

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The researchers found that during a median follow-up of 7.8 years, 72 percent of patients progressed to symptomatic WM. Independent predictors of disease progression included: immunoglobulin M ≥4,500 mg/dL, bone marrow lymphoplasmacytic infiltration ≥70 percent, β2-microglobulin ≥4.0 mg/dL, and albumin ≤3.5 g/dL. Using a proportional hazards model with bone marrow infiltration, immunoglobulin M, albumin, and beta-2 microglobulin values as continuous measures, the model characterized patients by risk: a high-risk group with a median time to progression (TTP) of 1.8 years, an intermediate-risk group with a median TTP of 4.8 years, and a low-risk group with a median TTP of 9.3 years. The model was validated in two external cohorts and demonstrated robustness and generalizability. When two cohorts were combined for greater power, wild-type MYD88 was identified as an independent predictor of progression (hazard ratio, 2.7).

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“This classification system is positioned to inform patient monitoring and care and, for the first time to our knowledge, to identify patients with high-risk AWM who may need closer follow-up or benefit from early intervention,” the authors write.

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